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Massachusetts rates for HCPCS Q2041

Axicabtagene ciloleucel, up to 200 million autologous anti-CD19 CAR positive T cells, including leukapheresis and dose preparation procedures, per therapeutic dose

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$537,031.80 / $741,310.24 / $1,122,018.45
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537,031.80 / $537,031.80 / $724,435.96
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$426,579.52 / $1,000,000.00 / $1,737,800.83
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537,031.80 / $537,031.80 / $1,995,262.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537,031.80 / $537,031.80 / $645,654.23
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $67,608.30 / $831,763.77
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457,088.19 / $457,088.19 / $457,088.19
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537,031.80 / $537,031.80 / $537,031.80
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$426,579.52 / $1,000,000.00 / $1,737,800.83
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537,031.80 / $537,031.80 / $1,995,262.31
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501,187.23 / $537,031.80 / $1,071,519.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32,359.37 / $32,359.37 / $537,031.80